Normal supine trauma chest x-ray
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Normal supine trauma chest x-ray in a 50yo male with widening of the mediastinal outline and venous congestion. Note how the aortic knuckle is poorly visualized. Subsequent CT chest was normal.
This chest x-ray emphasizes the fact that apparent mediastinal widening is often a normal finding in supine trauma patients and not necessarily indicative of mediastinal hematoma. This effect is more pronounced in elderly patients, obese patients and with radiographs taken during expiration or affected by rotation.